FREQUENCY OF HYPOCALCEMIC TETANY IN PATIENT UNDERGOING TOTAL AND NEAR TOTAL THYROIDECTOMY

A AHMAD; Z ALI; A GUL; U HAFEEZ; S AHMAD; HU REHMAN

doi:10.54112/pjicm.v5i02.133

Authors

A AHMAD Department of ENT, University Hospital Waterford, Ireland
Z ALI Department of ENT, Rehman Medical Institute, Peshawar Pakistan
A GUL Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Pakistan
U HAFEEZ Tallaght University Hospital, Ireland
S AHMAD Department of ENT, Lady Reading Hospital Peshawar, Pakistan
HU REHMAN Department of ENT, POF Hospital Wah Cantt Wah, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.133

Keywords:

Hypocalcemic Tetany, Total Thyroidectomy, Near-Total Thyroidectomy, Graves’ Disease

Abstract

Background: Hypocalcemic tetany is one of the most common and clinically significant complications following thyroid surgery. Its occurrence is primarily linked to hypoparathyroidism caused by inadvertent parathyroid injury or devascularization during surgery. Identifying its frequency and associated risk factors is crucial to improving patient safety and outcomes. Objective: To investigate the frequency of hypocalcemic tetany in patients undergoing total and near-total thyroidectomy. Study Design: Descriptive Case Series. Setting: The study was conducted at the Department of Otolaryngology, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: 1^st-December-2024 to 1st-June-2025. Methods: A total of 289 patients aged 20–60 years undergoing total or near-total thyroidectomy for goiter or Graves' disease were included. Hypocalcemic tetany was defined as the occurrence of carpopedal spasm with serum calcium <8.5 mg/dL within 72 hours postoperatively. Data were analyzed using descriptive statistics. Chi-square test was applied to determine associations between variables, with p ≤ 0.05 considered significant. Results: The mean age of participants was 36.22 ± 10.83 years. Of the total, 168 (58.1%) were females and 121 (41.9%) were males. Hypocalcemic tetany was observed in 15.6% of patients, with significantly higher incidence among females (73.3% vs. 26.7% males, p = 0.02) and in those with Graves' disease compared to goiter (73.3% vs. 26.7%, p = 0.01). Postoperative calcium supplementation was associated with a reduced risk of tetany. Conclusion: Hypocalcemic tetany was identified in 15.6% of patients following total and near-total thyroidectomy. Female gender and Graves' disease were significant predictors. Prophylactic calcium supplementation may play a protective role in reducing postoperative complications.

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